“We cannot accept ongoing marginalization of half the world’s population”
- Sec. Hillary Clinton

Jan 8, 4pm - Secretary of State Hillary Rodham Clinton just completed a major speech commemorating the 15th anniversary of the International Conference on Population and Development (ICPD) in support of women’s rights to reproductive health and family planning. Secretary Clinton highlighted the importance of ensuring women’s access to reproductive health and family planning services and helping women and girls lead healthy, productive and fulfilling lives.  She also emphasized that we must advocate for equity on behalf of women and girls and that they should, and will, be a central part of the United States foreign policy.   View the speech at www.icpd2015.org

Dear Colleague,

I am writing to ask you, and every single NASW member, to contact your members of Congress and show your full support for the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act (H.R. 795/ S.686) . This is the first piece of federal legislation ever introduced that will directly address the workforce challenges that our profession is facing. These challenges, such as low salaries, high educational debt, and serious safety concerns are making it difficult to assist the 10 million clients that social workers across the country serve each day. Take a moment to view this CNNmoney.com study, which rates social work at the top of the list of stressful jobs that pay badly. Rep. Towns recently discussed this study in a “Dear Colleague” he sent to his fellow members of Congress asking for their support for H.R. 795.

The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act is designed to address the workforce challenges we are facing, thereby helping to ensure that millions of individuals and families throughout the nation can continue to receive competent social work care.  The legislation will establish a Social Work Reinvestment Commission to provide a comprehensive analysis of current workforce trends and develop long-term recommendations and strategies to ensure an adequate social work workforce.  In addition, demonstration programs will award grants in the areas of workplace improvements, research, education, training, and community-based programs of excellence.

We also want to thank social workers, Representative Towns and Senator Mikulski, for introducing this legislation and for their consistent dedication and leadership of the social work profession.  We hope you will take a moment to thank them too. You can print this postcard and mail it to Senator Mikulski and Representative Towns or you can send them a quick thank you email. (View Senator Mikulski’s and Representative Towns’ contact information.) It’s important to remember and thank our social work advocates in Congress!

As always, we appreciate your advocacy and leadership on the issues that are important to our profession.

Sincerely,

Executive Director
Elizabeth J. Clark, PhD, ACSW, MPH

Because Congress will be in recess for the Thanksgiving holiday, there will be no Health Care Roundup on Tuesday, December 1. The next publication will be on Tuesday, December 8.

Rally on Reproductive Choice in Health Care Reform

The U.S. House of Representatives passed an amendment to the health care reform legislation sponsored by Bart Stupak (MI-1) and Joe Pitts (PA-16). This amendment would restrict access to abortion procedures for consumers who receive subsidies to buy insurance in a reconfigured health care system. Pro-choice organizations are very concerned the new language threatens the availability of private insurance coverage for comprehensive reproductive health care services.

NASW is co-sponsoring a rally and lobby day on Wednesday, December 2. The day starts at 9am with a lobby training followed by a briefing from 9:30 - 10:30am. Lobby visits from 10:30-11:30.  There will be an event from 12:00-2:00 and more lobby visits from 2:00-4:30.  Events will take place in the Dirksen Auditorium G-50. A wrap up will take place at 4:30 in Rayburn Banquet Room B369. If you would like to participate in the lobby day, please contact Dina Kastner at advocacy@naswdc.org (the mailbox is now accepting messages) so she can set up appointments for you.

Senate Opens Floor Debate on Health Reform

On Saturday, November 21 the U.S. Senate agreed to hold debate on health reform legislation known as the “Patient Protection and Affordable Care Act,” (H.R. 3590). The bill is expected to be on the floor for several weeks after Thanksgiving and will require significant changes to clear the filibuster hurdle of 60 votes to secure passage. NASW plans to strongly support passage, but will also support changes in the bill including those that improve coverage and protect against any weakening amendments of women’s rights to reproductive choices. NASW expects to be very actively involved in this debate; members wishing to keep up to date on our activities should visit our health reform webpage here.

Financial Impact of Health Reform

There is a great deal of analysis available on health reform legislation, but information from non-partisan congressional sources, such as the Congressional Budget Office, is frequently most pertinent to legislative decision making. Readers interested in learning more about the impact of health care reform legislation on federal spending may wish to view congressional analyses of the legislation.  These two inks summarize the budgetary impact of the House bill, HR. 3962: Health Care by the Numbers and Controlling Health Care Costs.

The Senate bill the “Patient Protection and Affordable Care Act,” (H.R. 3590) is still new so nonpartisan analyses of its budgetary impact are still becoming available. One summary is linked here and more information appears here. A brief comparison of the Senate and House versions of health reform legislation is available by this link to a Washington Post interactive site.

HHS Secretary Kathleen Sebelius on Monday announced the release of Health Insurance Reform: The Case for Change, a series of state-by-state reports highlighting the benefits of health insurance reform. The reports are available now here.

Medicare Fee Fix Passes House Floor Moves to Senate

The House passed legislation H.R. 3961 on November 19, which would prevent a scheduled 21 percent cut in Medicare doctors’ payment rates, although its fate remains uncertain. Without congressional action, payment rates for Medicare physician and clinical social worker services will drop by 21 percent on January 1, 2010. The prospect of steep payment cuts has raised fears that care to beneficiaries could be disrupted. The fate of corrective legislation that would permanently repeal the flawed sustainable growth rate (SGR) formula that determines future payment rates in Medicare and TRICARE remains uncertain. The SGR formula is frequently inappropriately described as the Medicare “physician fee” formula, but it actually sets the overall rate of increase or decrease for all Medicare Part B independent practitioners, including clinical social workers. NASW supports corrective legislation that would halt scheduled cuts in Medicare payments to clinical social workers and other health professionals and has urged Congress to adopt a plan to recalibrate how those payments are set each year. See NASW’s letter to Congress here.

Correcting the problem before the rate cuts go into effect on Jan. 1, will be politically extremely difficult. The Senate’s huge health care reform bill (H.R. 3590) includes short-term Medicare rate relief, but this provision is highly controversial and may change during floor consideration. Currently, the Senate plans to return to its physician payment bill once they finish work on health care reform, likely meaning it won’t be considered until sometime after the cuts go into effect on Jan. 1. Congress in the past has occasionally failed to enact the physician payment legislation in time, but has simply later passed retroactive legislation that restores the payment rates. Current law requires even further reductions in Medicare physician fees, a loss which will total to a 40 percent cut by 2016. If the Senate agrees to separate physician payment legislation, it may simply approve the House passed bill, but for now, a politically acceptable solution has not been identified.

Health Technology Loan Measure Passed by House

On November 18, the House passed, by voice vote, a bill (HR 3014) creating a new program to be administered by the Small Business Administration that would guarantee small business loans to health professionals such as clinical social workers and physicians to obtain health information technology for use in small or independent health practices. Eligible health information technology includes computer hardware, software, and related technology that supports the meaningful electronic health record use requirements of Medicare and purchased by an eligible professional to aid in the provision of health care, including electronic medical records. Information technology whose sole use is financial management, maintenance of inventory of basic supplies, or appointment scheduling would not qualify for the loan program. The legislation has been referred to the Senate where action is uncertain at this time.

GINA Employment Provisions Take Effect

On November 21, the Genetic Information Nondiscrimination Act (GINA) took effect for all employers with 15 or more employees and it took effect for individual health insurance plans last May.

GINA was passed by Congress last year and prohibits the use by employers of genetic or family medical history in making hiring, firing, promotion or job placement decisions.  Employers cannot require employees to undergo a genetic screening or ask employees for such medical information.

In related news, NASW joined various groups on a letter to the Department of Labor, Department of Health and Human Services and the Internal Revenue Service stating our opposition to any delay or weakening of the GINA regulations.  The letter states, “any delay in implementation would continue to allow employers to inquire about employees’ private genetic information or their families’ medical history, while penalizing employees who choose to keep that information private; any such exemption would create a loophole to significantly weaken the protections afforded to employees and the American people under GINA”.

On November 21, the Genetic Information Nondiscrimination Act (GINA) took effect for all employers with 15 or more employees and it took effect for individual health insurance plans last May.

GINA was passed by Congress last year and prohibits the use by employers of genetic or family medical history in making hiring, firing, promotion or job placement decisions. Employers cannot require employees to undergo a genetic screening or ask employees for such medical information.

In related news, NASW joined various groups on a letter to the Department of Labor, Department of Health and Human Services and the Internal Revenue Service stating our opposition to any delay or weakening of the GINA regulations. The letter states, “any delay in implementation would continue to allow employers to inquire about employees’ private genetic information or their families’ medical history, while penalizing employees who choose to keep that information private; any such exemption would create a loophole to significantly weaken the protections afforded to employees and the American people under GINA”.

To read the testimony click here.

On November 5, 2009, NASW submitted testimony in collaboration with the National Child Abuse Coalition, Washington, D.C., to the Subcommittee on Healthy Families and Communities, Committee on Education and Labor, U.S. House of Representatives, regarding the reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA). Congress has not yet introduced any legislation in the House or the Senate to reauthorize CAPTA. It is speculated that a bill may not emerge until next session as health care continues to dominate the legislative agenda.

The National Child Abuse Coalition, representing a collaboration of national organizations committed to strengthening the federal response to the protection of children and the prevention of child abuse and neglect, called on Congress to reauthorize the Child Abuse Prevention and Treatment Act (CAPTA) programs to provide the core federal policy and support for:

• strengthening the child protective services (CPS) infrastructure;
• promoting community-based services to prevent child maltreatment; and
• initiating research and development of innovative programs to advance the field of prevention and treatment of child abuse and neglect.

Testimony highlighted key findings from NASW’s Workforce report, Assuring the Sufficiency of a Frontline Workforce: A National Study of Licensed Social Workers. The study warns of an impending shortage of social workers that threatens future services for all Americans, especially the most vulnerable among us, children and older adults.

House Passes Health Care Reform Legislation

In an historic vote, the House passed major health care reform legislation on November 7, with a vote of 220-215. NASW strongly supports the health care reform bill (H.R. 3962), which included a Medicare provision allowing clinical social workers to bill independently for serving certain nursing home residents. A copy of NASW’s endorsement letter highlighting provisions of great concern to social workers is linked here.

Abortion Emerges as Major Controversy in Reform

During negotiations leading up to passage, a new unsettled question arose over whether consumers who buy insurance without any government subsidy will be able to obtain insurance that covers abortion services through the federal insurance exchange established in the bill.

Abortion rights advocates and opponents agree the House language spearheaded by Bart Stupak, D-MI, would restrict access to abortion procedures for consumers who receive subsidies to buy insurance in a reconfigured health care system. Anti-abortion groups say the amendment explicitly bars private insurers from including abortion coverage in plans they sell in the exchange to consumers who pay the premiums out of pocket, but pro-choice organizations are very concerned the new language goes much further and threatens the availability of private insurance coverage for these services. NASW opposes the Stupak amendment and is working with pro-choice groups to eliminate it in the Senate and final bill. The Senate will begin consideration of health reform legislation next week, and differences between the House and Senate version will ultimately be worked out in a conference committee.

NASW Acts on New Medicare Provider Enrollment Barrier

NASW plans to join with a large coalition of medical and health care practitioner groups to urge the Centers for Medicare and Medicaid Services, (CMS) to halt implementation of a new payment policy affecting clinical social workers and other health professionals that bill independently under Medicare Part B. The new administrative barrier concerns PECOs, a database that clinical social workers will soon be required to enroll in as a condition of participation in Medicare Part B. In 2003, Medicare switched to the new PECOS database for Medicare providers.  Recently Medicare claims have been denied for any provider who is not in the PECOS system, although practitioners were not told they needed to re-enroll as Medicare providers so they could be in the PECOS system.  There are nearly 800,000 Medicare providers, but only over 500,000 have enrolled in PECOS up to the present.  The remaining 300,000 providers must re-enroll and get revalidated.  This process is similar to many insurance company processes and is long and cumbersome.  Claims by these 300,000 providers are now being denied and electronic claims are being denied immediately.  Those submitting paper claims are not being paid, but without explanation.

FTC Red Flags Rule Enforcement Delayed

The FTC has announced that it is again delaying enforcement of the “Identity Theft Red Flags” Rule” until June 1, 2010. The rules would have directly affected clinical social workers in small private and group practices. One of the controversial aspects of the Rule was its applicability to health care professionals, particularly small or solo practitioners.  The Rule has been delayed previously on two separate occasions.  NASW provided information about the identity theft regulations in the June 2009 LDF Legal Issue of the Month and the article may be accessed here.

As the regulatory situation has grown more difficult, a number of health and other professionals have approached Congress seeking a legislative solution. Congress has responded with quick movement on a bill, H.R. 3763, which would exclude licensed health practitioners with fewer than 20 people in a practice from reporting under the Fair Credit Reporting Act and from the Red Flags Rule. The bill was introduced in the House and passed the floor a brief three weeks after introduction. It is now pending before the Senate where momentum could slow down in response to the FTC’s action postponing implementation of the regulation. More information is available at an FTC website here.

The Honorable Edolphus Towns
Date: 11/6/2009

Dear Colleague:

I wanted to call your attention to an article on cnn.com highlighting the top 15 “stressful jobs that pay badly.” The number 1 job listed — social work. This article highlights one  of the key problems in recruiting and retaining qualified individuals who will “step in when others step aside.”

My bill, HR 795, the Dorothy I. Height and Whitney M. Young Social Work Reinvestment Act, aims to solve this problem by establishing a commission to study the policies needed to recruit and retain qualified social workers in a time when they are needed the most. Social workers focus their practice on those who are most vulnerable in society. With the economic downturn, their caseloads are only increasing, while salaries and positions are being cut.

For more information, here is the article from cnn.com:

Social worker

Median pay: $43,200
% who say their job is stressful: 72%

Social workers step in when everyone else steps aside to help people and families in vulnerable situations. They provide patients with education and counseling, advise care givers and make referrals for other services. And with social workers in short supply and programs underfunded, few must juggle the work of many, while reaping little reward.

Just ask Heather Griffith, a social worker who works with children in intensive foster care in Boston: “You’re getting paid $12 an hour and kids are screaming at you, telling you that you are just in it for the money and you’re just like, really?”

http://money.cnn.com/galleries/2009/pf/0910/gallery.stressful_jobs/index.html

Regards,

Edolphus “Ed” Towns
Member of Congress

NASW Calls for Increased Mental Health Funding

The National Association of Social Workers has joined with the Mental Health Liaison Group (MHLG), a coalition of national organizations representing the diverse mental health advocacy community, in calling for higher federal funding levels for mental health services, supports and research.  The coalition argues that higher federal funding levels are essential to meet the extraordinary mental health needs of communities throughout the nation, which are especially strained by the extraordinary economic crisis. NASW and MHLG called on the Congress to go above the Administration’s proposed increases for the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institutes of Health (NIH), which includes funding for the National Institute of Mental Health (NIMH).

In a coalition letter signed by NASW, the group called for funding increases in overlooked federal mental health programs, including increases for the mental health block grant and consumer-centered programs, among others, whose funding levels have remained stagnant for nearly a decade.  NASW and the coalition are pursuing a comprehensive funding approach, advocating for a broad array of services and supports to address the needs of all communities with many residents who have been affected by the crisis, and because of the likelihood that every state will be forced to reduce services. For a copy of NASW’s coalition letter to Congress, see here. 

Congress Negotiates Health Reform Details

Democratic leaders continue to convene in high level meetings to work out the details of comprehensive health reform bills headed soon to the House and Senate floor. With critical decisions being worked out behind closed doors, advocacy organizations are scrambling to learn how their top priority concerns are faring in the ongoing negotiations. NASW continues to press for a variety of priorities including expanding coverage of the uninsured and ensuring that health disparities are addressed. NASW members interested in learning the details of the various bills may access two new resources to compare the various bills on a wide range of variables.  Follow this link to a new Kaiser Family Foundation’s side by side document comparing the major health care reform bills and also this one of a new Commonwealth Fund analysis of the major health care reform bills.

Social Work Medicare Equity Act Language Included in House Bill

Section 1307 of the House Bill (H.R. 3200) includes language that removes clinical social work services from the Skilled Nursing Facility (SNF) per diem rate and alternatively authorizes independent practitioners to bill for them independently. With this provision, licensed clinical social workers that participate in Medicare will be able to bill Medicare directly. This is a long-sought change by NASW and a critical parity provision for clinical social workers that will expand the availability of services to certain Medicare SNF residents. 

 Political Climate

Senate Majority Leader Harry Reid has sent a health care reform bill containing a “state opt out” to the Congressional Budget Office (CBO) for scoring, or a determination of how much the bill would cost.  The “opt out” would permit individual states to remove themselves from the federal insurance program if they wish.  Sending the bill to the CBO is a strong indication that Reid believes he can pass a “state opt out” bill through the Senate with at least 60 votes (and exactly 60 votes, in all likelihood).  Speaker Pelosi has expressed a strong preference for a bill containing some kind of public option, but has indicated that a “state opt out” would accomplish many of the same goals and does not believe it would hinder the progress of a final bill.  If Sen. Reid can secure 60 votes for this bill, the process of reconciliation with the House bill would then commence, before a final version is sent to the White House.

Best Practices and Lessons Learned: Shaping National Health Care Reform

Kyrsten Sinema, MSW, JD is a social worker, NASW member and a member of the Arizona legislature, serving as Arizona’s Assistant House Democratic Leader. She led a Lunch Time Series teleconference to discuss federal health care reform. Sinema is one of 32 state legislators nationwide — the only state lawmaker from Arizona — selected for President Obama’s White House Health Reform Task Force. She provided an overview of the various health reform proposals being considered. NASW members can read the transcript online.

Benjamin Confirmed as U.S. Surgeon GeneralOn October 29, the full senate unanimously approved Regina Benjamin, MD as U.S. Surgeon General.  The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps (PHSCC) and thus the leading spokesperson on matters of public health in the federal government.

First announced as the U.S. Surgeon General nominee on July 13, 2009, Dr. Regina Benjamin was the founder and chief executive officer of the Bayou La Batre Rural Health Clinic in La Batre, LA, the immediate past chair of the Federation of State Medical Boards of the United States and previously served as associate dean for rural health at the University of South Alabama College of Medicine. In 2002, as the president of the Medical Association of the State of Alabama, she became the first black woman to be president of a U.S. state medical society. 

NASW supported Dr. Benjamin’s confirmation.

Congress is working to pass major health care reform legislation, and the full House will consider a bill over the next several days that will meet many of the needs of the American populace. “The Affordable Health Care for America Act of 2009,” (H.R. 3692) provides more affordable quality coverage for millions, calls for shared responsibility by individuals, employers and government, and expands health insurance coverage choices, including being able to retain one’s current coverage, having additional private plan options and offering a public health insurance option designed to lower costs and keep insurance companies accountable. NASW strongly supports this compromise legislation and has called on Congress to pass comprehensive health care reform now. See NASW’s letter of support here.

The National Association of Social Workers has steadfastly been involved with hate crimes legislation for over a decade. On October 22, 2009 NASW’S tireless efforts came to fruition with the passage, by the Senate, of the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act by a 68-29 vote. The hate crimes initiative was included in the Fiscal Year 2010 Department of Defense Authorization Report passed previously by the House of Representatives. The historic enactment of hate crimes legislation represents a vital victory for social justice advocates and all Americans who affirm that inequality and intolerance corrupt Democratic principles and ideals.

Consistently, many Americans are victims of violent crimes due to their race, religion, sexual orientation, gender, gender identity and disability. The Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act will realign significant federal resources to aide local law enforcement efforts in the fight against hate crimes, racism and intolerance against those who exercise their right to alternative lifestyles. Further, the bill acknowledges that gender identity must be protected under federal law. The Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act is our nation’s sincerest attempt statutorily at protecting the civil rights of the lesbian, gay, bisexual and transgender communities. NASW strongly believes that the enactment of this legislation affirms America’s commitment and moral imperative that all of its citizens are one. Today, Social Workers should be proud that lawmakers have reaffirmed the intrinsic values of our profession and its unwavering pursuit of equality for all.